Characteristics of re-admitted adult patients infected with severe acute respiratory syndrome Coronavirus 2 After initial hospitalization at King Salman Armed Forces Hospital, Tabuk, Saudi Arabia

Hanaa Albalawi; Rashed Albalawi; Riham Hamza; Abdulaziz Galdagoun; Noura S. Aljofi; Khaled Elgohary; Samira Fallatah

doi:10.15537/smj.2023.44.7.20220713

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Figure 1
- Rate of readmission among patients admitted for COVID-19 at King Salman Armed Forces Hospital, Tabuk (March-November 2020).

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Table 1

- Demographic, personal, and clinical characteristics of patients admitted for Covid-19 at King Salman Armed Forces Hospital, Tabuk (March-November, 2020) (N=237).

Characteristics	n	%
Gender
Female	98	41.4
Male	139	58.6
Age (years)
≤64	152	64.1
≥65	85	35.9
Body mass index (n=163)
Underweight	1	0.6
Normal	30	18.4
Overweight	63	38.7
Obese	69	42.3
Current smoking	6	2.6
Current pregnancy (n=98)	8	8.2
Duration of symptoms till presentation to ER (days) (n=231)
≤3	115	49.7
4-7	87	37.7
>7	29	12.6
Presenting symptoms (n=236)
Fever	172	72.9
Chills	88	37.3
Sweating	86	36.4
Cough	176	74.6
Sputum	32	13.7
Headache	66	28.0
Loss of smell	2	0.8
Sore throat	34	14.4
Dyspnea	153	64.8
Chest pain	7	3.0
Abdominal pain	24	10.2
Nausea	48	20.3
Vomiting	39	16.5
Diarrhea	40	16.9
Loss of appetite	30	12.8
Body ache	58	24.6
Vital signs
Maximum temperature
<37.7	127	53.6
≥37.7
Oxygen saturation “%” (n=235)	110	46.4
≥93	83	35.3
<93	152	64.7
Comorbid diseases
Diabetes mellitus (n=231)	121	52.4
Hypertension (n=229)	112	48.9
Sickle cell disease (n=228)	1	0.4
Chronic lung diseases (n=228)	24	10.5
Heart diseases (n=228)	29	12.7
Immune compromised (n=229)	5	2.1
Cancer (n=229)	2	0.9
Kidney diseases (n=229)	24	10.1
Rheumatic diseases (n=185)	2	1.1
Cerebrovascular accident (n=77)	9	11.7
Renal transplant (n=229)	4	1.7
Mild	58	25.2
Moderate	23	10.0
Severe	115	50.0
Critical	23	14.8

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Table 2

-Results of laboratory investigations of patients admitted for Covid-19 at King Salman Armed Forces Hospital, Tabuk (March-November 2020) (N=237).

Laboratory investigations	n	%
White blood cell count (per microliter) (n=232)
<4000	10	4.3
4000-11000	145	62.5
>11000	77	33.2
Platelets (per microliter) (n=232)
<150,000	49	21.1
15000-400000	174	75.0
>400000	9	3.9
Lymphocytes (per microliter) (n=231)
<1	29	12.6
1-3	198	85.7
>3	4	1.7
Erythrocyte sedimentation rate (mm/hr) (n=89)
1-31	11	12.4
>31	78	87.6
C-reative protein (mg/dL) (n=168)
0.0-0.3	10	6.0
>0.3	158	94.0
Ferritin (micrograms per liter) (n=121)
3-244	45	37.2
>244	76	62.8
D-Dimer (g/L) (n=202)
0-0.5	60	29.7
>0.5	142	70.3
Creatine kinase (U/L) (n=119)
<26	5	4.2
26-192	83	69.7
>192	31	26.1
Low density lipoprotein (mg/dL) (n=212)
81-234	39	18.4
>234	173	81.6
Albumin (g/dL) (n=224)
34-50	74	33.0
>50	150	67.0
Total bilirubin (mg/dL) (n=225)
0-14	201	89.3
>14	24	10.7
AST (units per liter) (n=221)
<15	9	4.1
15-37	107	48.4
>37	105	47.5
ALT (units per liter) (n=227)
<30	95	41.9
30-65	89	39.2
>65	43	18.9
Alkaline phsphatase (U/L) (n=163)
<50	15	9.2
50-136	133	81.6
>136	15	9.2
Creatinine (mg/dL) (n=225)
<53	19	8.4
53-115	163	72.5
>115	43	19.1

AST: aspartate transaminase ALT: alanine transaminase

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Table 3

- Demographic and personal factors associated with readmission of COVID-19 cases after hospital discharge (N=237).

Characteristics	Hospital readmission		P-value
Characteristics	No n=223	Yes n=14	P-value
Gender
Female	94 (95.9)	4 (4.1)	0.238^*
Male	129 (92.8)	10 (7.2)	0.238^*
Age (years)
≤64	148 (97.4)	4 (2.6)	0.006^*
≥65	75 (88.2)	10 (11.8)	0.006^*
Body mass index (n=163)
Underweight	1 (100)	0 (0.0)	0.997^**
Normal	29 (96.7)	1 (3.3)
Overweight	61 (96.8)	2 (3.2)
Obese	67 (97.1)	2 (2.9)
Current smoking
No	214 (96.8)	7 (3.2)	0.827^*
Yes	6 (100)	0 (0.0)	0.827^*
Current pregnancy (n=98)
No	215 (93.9)	14 (6.1)	0.610^*
Yes	8 (100)	0 (0.0)	0.610^*

↵* Fischer exact test
↵** Chi-square test

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Table 4

- Clinical factors associated with readmission of COVID-19 cases after hospital discharge (N=237).

Clinical factors	Hospital readmission		P-value
Clinical factors	No n=223^{^‡}	Yes n=14^{^‡}	P-value
Severity (n=230)
Mild	57 (98.3)	1 (1.7)	0.031^{^*}
Moderate	23 (100)	0 (0.0)
Severe	109 (94.8)	6 (5.2)
Critical	29 (85.3)	5 (14.7)
Duration of symptoms before presentation (n=231)
≤3	105 (91.3)	10 (8.7)	0.067^*
4-7	86 (98.9)	1 (1.1)	0.067^*
>7	27 (93.1)	2 (6.9)
Maximum temperature
<37.7	118 (92.9)	9 (7.1)	0.408^*
≥37.7	105 (95.5)	5 (4.5)
Oxygen saturation (n=235)
≥93	81 (97.5)	2 (2.4)	0.102^**
<93	141 (92.8)	11 (7.2)
Fever (n=236)
No	58 (90.6)	6 (9.4)	0.172^*
Yes	164 (95.3)	8 (4.7)
Chills (n=236)
No	139 (93.9)	9 (6.1)	0.900^*
Yes	83 (94.3)	5 (5.7)
Sweating (n=236)
No	140 (93.3)	10 (6.7)	0.528^**
Yes	82 (95.3)	4 (4.7)
Cough (n=236)
No	54 (90.0)	6 (10.0)	0.122^*
Yes	168 (95.5)	8 (4.5)
Sputum (n=234)
No	189 (93.6)	13 (6.4)	0.403^**
Yes	31 (96.9)	1 (3.1)
Headache (n=236)
No	158 (92.9)	12 (7.1)	0.196^**
Yes	64 (97.0)	2 (3.0)
Loss of smell (n=236)
No	220 (94.0)	14 (6.8)	0.885^**
Yes	2 (100)	0 (0.0)
Sore throat (n=236)
No	188 (93.1)	14 (6.9)	0.106^**
Yes	34 (100)	0 (0.0)
Dyspnea (n=236)
No	79 (95.2)	4 (4.8)	0.414^**
Yes	143 (93.5)	10 (6.5)
Chest pain (n=236)
No	216 (94.3)	13 (5.7)	0.352^**
Yes	6 (85.7)	1 (14.3)
Abdominal pain (n=236)
No	198 (93.4)	14 (6.6)	0.213^**
Yes	24 (100)	0 (0.0)
Nausea (n=236)
No	176 (93.6)	12 (6.4)	0.430^**
Yes	46 (95.8)	2 (4.2)
Vomiting
No	184 (93.4)	13 (6.6)	0.292^**
Yes	38 (97.4)	1 (2.6)
Diarrhea (n = 236)
No	183 (93.4)	13 (6.6)	0.278^**
Yes	39 (97.5)	1 (2.5)
Loss of appetite (n=235)
No	195 (95.1)	10 (4.9)	0.087^**
Yes	26 (86.7)	4 (13.3)
Body ache (n=236)
No	167 (93.8)	11 (6.2)	0.535^**
Yes	55 (94.8)	3 (5.2)
Chest x-ray (n=234)
Normal	53 (100)	0 (0.0)	0.004^*
Unilateral shadow	38 (84.4)	7 (15.6)	0.004^*
Bilateral shadow	129 (94.9)	7 (5.1)
ICU admission (n=234)
No	185 (96.4)	7 (3.6)	0.006^*
Yes	36 (85.7)	6 (14.3)
Blood culture (n=211)
Negative	192 (95.0)	10 (5.0)	0.640^**
Positive	9 (100)	0 (0.0)
Sputum culture (n=220)
Negative	199 (95.2)	10 (4.8)	0.114^**
Positive	9 (81.8)	2 (18.2)

↵* Chi-square test
↵** Fisher exact test
↵^‡ Difference due to missing values, ICU: intensive care unit

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Table 5

- Medical history associated with readmission of COVID-19 cases after hospital discharge (N=237).

Medical history	Hospital readmission		P-value^{^*}
Medical history	No n=223^{^‡}	Yes n=14^{^‡}	P-value^{^*}
Diabetes mellitus (n=231)
No	107 (97.3)	3 (2.7)	0.299
Yes	115 (95.0)	6 (5.0)	0.299
Hypertension (n=229)
No	113 (96.6)	4 (3.4)	0.615
Yes	108 (96.4)	4 (3.6)	0.615
Sickle cell disease (n=228)
No	220 (96.9)	7 (3.1)	0.969
Yes	1 (100)	0 (0.0)	0.969
Chronic lung diseases (n=228)
No	197 (96.6)	7 (3.4)	0.454
Yes	24 (100)	0 (0.0)	0.454
Heart diseases (n=228)
No	194 (97.5)	5 (2.5)	0.219
Yes	27 (93.1)	2 (6.9)	0.219
Immune compromised (n=229)
No	217 (96.9)	7 (3.1)	0.855
Yes	5 (100)	0 (0.0)	0.855
Cancer (n = 229)
No	220 (96.9)	7 (3.1)	0.940
Yes	2 (100)	0 (0.0)	0.940
Kidney diseases (n=229)
No	199 (97.1)	6 (2.9)	0.544
Yes	23 (95.8)	1 (4.2)	0.544
Rheumatic diseases (n=185)
No	178 (97.3)	5 (2.7)	0.064
Yes	1 (50.0)	1 (50.0)	0.064
Cerebrovascular accident (n=77)
No	67 (98.5)	1 (1.5)	0.035
Yes	7 (77.8)	2 (22.2)	0.035
Renal transplant (n=229)
No	218 (96.9)	7 (3.1)	0.882
Yes	4 (100)	0 (0.0)	0.882

↵* Fischer exact test
↵^‡ Difference due to missing values

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Table 6

- Laboratory findings associated with readmission of COVID-19 cases after hospital discharge (N=237).

Laboratory findings	Hospital readmission		P-value
Laboratory findings	No n=223^{^‡}	Yes n=l4^{^‡}	P-value
White blood cell count (permicroliter) (n=232)
<4000	10 (100)	0 (0.0)	0.652^*
4000–11000	138 (95.2)	7 (4.8)
>11000	72 (93.5)	5 (6.5)
Platelets (per microliter) (n=232)
<150,000	45 (91.8)	4 (8.2)	0.366
15000–400000	167 (96.0)	7 (4.0)
>400000	8 (88.9)	1 (11.1)
Lymphocytes (per microliter) (n=231)
<1	24 (82.8)	5 (17.2)	0.001^*
1–3	192 (97.0)	6 (3.0)
>3	3 (75.0)	1 (25.0)
Erythrocyte sedimentation rate (mm/hr) (n=89)
1–31	10 (90.9)	1 (9.1)	0.558^**
> 31	73 (93.6)	5 (6.4)	0.558^**
C-reactive protein (mg/dL) (n=168)
0.0–0.3	10 (100)	0 (0.0)	0.498^**
>0.3	147 (93.0)	11 (7.0)	0.498^**
Ferritin (micrograms per liter) (n=121)
3–244	43 (95.6)	2 (4.4)	0.604
>244	72 (94.7)	4 (5.3)	0.604
D-Dimer (g/L) (n = 202)
0–0.5	58 (96.7)	2 (3.3)	0.386^**
>0.5	134 (94.4)	8 (5.6)	0.386^**
Creatine kinase (U/L) (n=119)
<26	4 (80.0)	1 (20.0)	0.370^*
26–192	79 (95.2)	4 (4.8)
>192	29 (93.5)	2 (6.5)
Low density lipoprotein (mg/dL) (n=212)
81–234	38 (97.4)	1 (2.6)	0.315^**
> 234	162 (93.6)	11 (6.4)	0.315^**
Albumin (g/dL) (n=224)
34–50	67 (90.5)	7 (9.5)	0.055^*
>50	145 (96.7)	5 (3.3)	0.055^*
Total bilirubin (mg/dL) (n=225)
0–14	190 (94.5)	11 (5.5)	0.627^**
>14	23 (95.8)	1 (4.2)	0.627^**
AST (units per liter) (n=221)
<15	8 (88.9)	1 (11.1)	0.478^*
15–37	103 (96.3)	4 (3.7)
>37	98 (93.3)	7 (6.7)
ALT (units per liter) (n=227)
<30	89 (93.7)	6 (6.3)	0.577^*
30–65	86 (96.6)	3 (3.4)
>65	40 (93.0)	3 (7.0)
Alkaline phosphatase (U/L) (n=163)
<5	14(93.3)	7 (6.7)	0.563^*
50–136	125 (94.0)	8 (6.0)
>136	13 (86.7)	2 (13.3)
Creatinine (mg/dL) (n=225)
<53 (n = 19)	18 (94.7)	1 (5.3)	0.866
53–115 (n = 163)	155 (95.1)	8 (4.9)
>115 (n = 43)	40 (93.0)	3 (7.0)